When Toca.io first launched, healthcare wasn’t on the roadmap. The business, founded by Mat Rule in 2018, was a general-purpose low-code automation platform – smart, flexible, and designed to serve a wide range of sectors. The team had deep technical expertise and a growing customer base, especially in public sector environments. But they weren’t healthcare specialists. Not then.

Fast forward a few years, and things started to shift. A successful project with the Royal Berkshire NHS Foundation Trust, focused on automating referrals and reducing backlogs, unlocked something unexpected: momentum.

“We weren’t planning to go all-in on the NHS,” Mat reflects. “But we started to get drawn into this space where the problems were really tough, the stakes were high, and the value we could bring was clear.”

It wasn’t a deliberate pivot at first. More a gravitational pull.

The team built a product around NHS e-referrals that ended up being far more complex (but far more valuable) than initially expected. It was supposed to be a three-month project. It took eighteen. But by the end, they weren’t just building features, they were solving real operational pain points across entire clinical pathways.

That’s when the internal conversation began: maybe healthcare isn’t just another vertical. Maybe it’s the vertical.

But there was a problem.

“No one’s going to buy a healthcare platform from something called Toca.io,” Mat’s marketing lead told him bluntly. “If you’re serious about this, give it its own name and brand.”

Introducing Toca.Health

In early 2024, Toca.Health was born. This wasn’t a rebrand, but a new sub-brand designed to signal intent and credibility. While a lot of the team was shared – same tech, same developers, same knowledge & experience – Mat made the decision to invest in this with dedicated consultants and business development. He knew this was an area that needed good domain knowledge to be able to have relevant conversations with clients, and bring real value with their solution.

The market was responding. Their platform, now branded E-Triage, was processing 120,000 patients a year in one trust, with more knocking on the door.

But internally, things were less clear. The Toca team understood the tech. They understood the NHS. But the business strategy, the go-to-market plan, the commercial clarity, the messaging, the team alignment, was still catching up.

That’s when Mat reached out to Rachel Murphy and The Grafter.

“I’d known Rachel for a while and always respected her no-nonsense approach,” Mat says. “She gets the NHS, she’s been on the inside, she’s sold into the NHS, and I knew we needed someone who could ask the awkward questions.”

Clarifying the Mission

The engagement began with The Grafter’s Business Diagnostic, the first stage of their Grow Raise Exit programme. It’s designed to help founders step back from the day-to-day and look at their business through a strategic lens, not just for growth, but also for investment readiness or future exit planning.

For Mat, it wasn’t about preparing to sell. It was about getting clear.

“I wasn’t raising. I wasn’t exiting,” he explains. “But I wanted to be ready, ready for the unknown. Whether that’s investment, a partnership, or just growing properly. And that meant I needed to know where the gaps were.”

The Diagnostic helped surface those gaps. Some were expected, things like refining messaging, or clarifying the commercial model. Others were more surprising.

“We did a team session and Rachel asked everyone if they understood the strategy for Toca.io. Most people nodded. Then she asked about Toca.Health, and that’s when the silence kicked in.”

It was a wake-up call. While the leadership team had a vision, it hadn’t been fully shared, stress-tested, or documented. The lines between the parent business and the new sub-brand were blurred. That was fine in the short term, but it wouldn’t scale. That moment helped us rethink how we run leadership meetings and share information across the company.

Building the Plan

Where the Business Diagnostic surfaced the challenges, the Grow Raise Exit programme continued by giving structure, substance and direct action. Through the Grow Raise Exit program, Mat and the team began to formalise their thinking. That included:

“The process didn’t feel like generic business school stuff,” Mat says. “It was practical. Tactical. It helped me think more clearly about where we were strong, where we were exposed, and what we could do to build a solid, scale-ready business.”

One thing that stood out was the idea of building sophistication, not just speed.

“In the early days of Toca.io, we built  fast, delivered quick value, and that all helped us grow rapidly. But with Toca.Health, we needed to be more deliberate. This wasn’t a startup anymore, what we were building had to be right first time in a mission critical environment, something serious that people depended on.”

Looking Ahead

Toca.Health is now live across multiple trusts, with new implementations in the pipeline. The team has doubled down on their core NHS offer, but they’re also building in flexibility, developing reusable components and planning for broader applications in community care and beyond.

“Before this programme, if someone asked for an info memo or a data pack, I’d have scrambled,” Mat admits. “Now, we’re in a place where we can respond – professionally, quickly, and with a story that makes sense.”

The journey from generalist platform to focused healthtech brand hasn’t been dramatic or headline-grabbing. It’s been thoughtful, gradual, and sometimes a bit messy, like most real world progress.

But now, the strategy is clear. The foundation is stronger than ever. And the team are aligned around something they truly believe in.

“We love healthcare,” Mat says. “It’s complex, it’s messy, it’s critical. But that’s exactly why we’re in it.”